Endocrine, Bariatric and Metabolic Unit, General Surgery Department, University Hospital Vall d'Hebron, 08035 Barcelona, Spain.
Int J Endocrinol. 2011;2011:898302. doi: 10.1155/2011/898302. Epub 2011 Mar 6.
Thyroid gland involvement as the unique presentation of Langerhans cell histiocytosis is a rare phenomenon that can result in misdiagnosis. We report a case of Langerhans cell histiocytosis (LCH) presenting as a thyroid mass. It is a 52-year-old woman who presented an enlarged, diffusely firm, nontender, nonmobile, and not particularly nodular thyroid gland with mild compressive symptoms. Ultrasound and fine-needle aspiration showed a unique right node with benign signs. Patient was referred to our Ambulatory Surgery Department, where a hemithyroidectomy was performed. Histologic evaluation of the right thyroid gland revealed an involvement by LCH, confirmed by immunohistochemical analysis showing Langerhans cells that were positive for CD1a. LCH was a completely incidental occult finding apparent only after surgical resection and examination of the gland. Patient was evaluated, and no evidence of systemic affectation was found. LCH can rarely involve the thyroid gland in adults. Few cases have been reported in the literature. Most patients had evidence of LCH involving other anatomic sites.
甲状腺受累是朗格汉斯细胞组织细胞增生症的独特表现，这是一种罕见的现象，可能导致误诊。我们报告一例以甲状腺肿块为表现的朗格汉斯细胞组织细胞增生症（LCH）。这是一位 52 岁女性，甲状腺肿大，弥漫性坚实，无触痛，不活动，结节不明显，伴有轻度压迫症状。超声和细针抽吸显示右侧有一个具有良性特征的独特淋巴结。患者被转至我们的门诊外科，在那里进行了半甲状腺切除术。对右侧甲状腺的组织学评估显示 LCH 受累，免疫组织化学分析显示 Langerhans 细胞 CD1a 阳性，证实了这一诊断。LCH 是一种完全偶发的隐匿性发现，仅在手术切除和检查腺体后才明显。对患者进行了评估，未发现全身受累的证据。LCH 很少在成人中累及甲状腺。文献中报道的病例很少。大多数患者有 LCH 累及其他解剖部位的证据。
